The Mediterranean Diet

The Mediterranean diet has definitely taken hold everywhere around the world, becoming a real trend, but what does it really mean? This diet represents the expression of the lifestyle developed by the population of the Mediterranean area over the years. In fact, the word Diet that in Greek is “Diaita” means way of living. Considered as a treasure for all the humanity, the Mediterranean diet was inscribed in 2010 in the list of Intangible and Cultural Heritage of the UNESCO.

A piece of history

In the late ‘50s a US physiologist Dr Ancel Keys, considered the father of the Mediterranean Diet, designed an experiment called “Seven Countries Study”, where he discovered that this dietary pattern was leading to a better life expectancy, especially for the population of the Mediterranean area, compared to other countries. Unfortunately, this lifestyle was abandoned in the Sixties and Seventies during the economic boom, because it was considered poor and unattractive. Also, women who started working in factories, didn’t have enough time to spend in the kitchen and this opened the market to the processed food, which required less cooking time. However, starting from the ‘90s, the Mediterranean Diet has come back in fashion, becoming one of the healthiest nutritional models available in the market.

The pillars of the Mediterranean diet

The main pillar of this diet consists in consuming mostly fresh fruit and vegetable, whole grains, nuts, olive oil, lean sources of animal protein, a reduced amount of red meat and saturated fats, and few processed foods or refined sugars. Although consuming those foods in the right proportion has a positive impact on health status, the traditions of the Mediterranean population play an important role as well. First, the food is usually consumed in a relaxed atmosphere with family and friends, and this can bring benefit also to your digestive system, as you tend to chew better the food. Secondly, the food is prepared at home from scratch following traditional recipes, using fresh and seasonal ingredients, local herbs and spices. By cooking your own meal you can control the total amount of calories preventing weight gain; selecting fresh ingredients allows you to bring more nutrients in your daily diet and the use of herbs and spices reduce the salt intake, enhancing the flavour of the food. Lastly, regular exercise is always incorporated on a daily base because it is proven that it helps increasing the good cholesterol level and maintain a healthy body weight.

Health benefits of the Mediterranean diet

A recent review shows that following the Mediterranean Diet may improve overall health status reducing the risk of various diseases.

Fruit and vegetable contain antioxidants and vitamins, which may help our body to protect against cells damage caused by free radicals. Fruits and vegetables as well as legumes and oat contain soluble fiber, which demonstrated reduction of LDL blood cholesterol, improvement of blood sugar level and insulin sensitivity in clinical studies. Wholegrain products are higher in insoluble fiber helpful to regulate the intestinal transit. In addition, fiber with prebiotic effect, contained mostly in asparagus, legumes, oats, garlic, onion, bananas wholegrains and nuts, has been associated with the growth of beneficial bacteria in the gut, increasing the natural resistance to pathogens.

The Extravirgin Olive Oil is the protagonist of the Mediterranean diet. Studies suggests that due to its high content of oleic acid and polyphenols it may reduce inflammation, lower the blood pressure, reduce the risk of cancer and protect against type 2 diabetes. On top of that, it is considered the best for low and medium-heat cooking because of its large amount of monounsaturated fats, which are quite resistant to high temperature.

Nuts and seeds protect the cardiovascular system and they are largely used as a natural supplements because they are high in minerals and proteins.

Lastly, omega-3 fatty acids, which are packed in oily fish, have anti-inflammatory properties and sustain brain functions as widely supported by scientific research.

Nowadays quite a number of different diets are available in the market, but overall the Mediterranean diet still remains one of the healthiest diets to follow especially in the long term.

Biography

Veronica Cavallini is an Italian Dietitian holding a BSc in Dietetic and a MSc in Human Nutrition and Food Science. She is a full member of the Singapore Nutrition and Dietetic Association and Accredited Dietitian of Singapore and Italy. She has a special interest in the treatment of gastrointestinal conditions, food allergies and intolerances, obesity and eating disorders. She likes to travel, especially in developing countries where she was involved in different programs to improve quality of life in populations at risk of malnutrition. She is currently working as a Nutritional Consultant at Andrea’s Digestive, Colon, Liver and Gallbladder Clinic. For more information please visit www.andrea-digestive-clinic.com

Flexitarianism

Flexitarianism has definitely taken hold everywhere around the world, becoming a real trend. It’s a new concept of diet, that gives more flexibility combining vegetable proteins with animal proteins few times a week.

The main pillar of the vegetarian diet consists in consuming mainly legumes, vegetables, cereals, seeds and good fats. The legumes are the protagonists of the protein intake, from peas to beans, broad beans, chickpeas and lentils, that offers the possibility to prepare a variety of dishes in many ways and forms.

There is a big debate regarding the quality of animal and vegetable protein in terms of essential amino acid content. Animal proteins contains all the essential amino acids in the correct proportions, hence they are considered of high biological value, while the vegetables can have an incomplete amino acid profile. For this reason the combination of grains and legumes in the same dish (eg. rice and lentils) represents the better substitute of a slice of meat than legumes on its own, as grains contains a different amino acid missing in the legumes.

Furthermore, legumes, as well as fruit, vegetables and oat, contain soluble fiber that can bring to gut a lot of health benefits. Fiber is essential to prevent constipation, hence reducing exposure of the colonic mucosa to waste products. It has prebiotic function, stimulating the growth of beneficial bifidobacteria and lactobacilli in the gut, increasing the natural resistance to pathogens. Finally, the bacterial fermentation in the large intestine and production of short chain fatty acids play role in reduction of risk of colon cancer.

Although legumes have a good overall impact in diet, some “undesirable effects” like flatulence and bloating could be frequently experienced. Furthermore, legumes have some anti-nutritional functions, in fact, during their digestion reduction in digestive efficacy towards proteins and starch is observed, as well as reduction of absorption of iron, zinc, calcium and magnesium is reduced due to some anti-nutrient molecules. Overall, thanks to the high intake of plant-based foods (typically low in saturated fat, rich in polyunsaturated fat and in soluble and insoluble fiber, high in phytochemicals), vegeterians have less risk for development of certain type of cancer and other diseases. However, strict vegetarian diet without any animal proteins may cause various nutritional deficiencies (iron, calcium, vitamin D, vitamin B12 and protein deficiency).

As per all the above reasons, I think the flexitarian diet is a good compromise: having few times per week more variety of animal proteins will also provide better variety of different vitamins and mineral lacking in pure vegetarian diet. The problem of certain animal proteins lies in the way they interact with our organism. Several studies shows that high red meat consumption and the mode of its preparation is associated with increased risk of development of colon cancer. That’s why, although there is no need to completely remove red meat from the diet, it is recommended to reduce intake of red meat once a week.

In conclusion, here are few tips for flexitarian diet:

• eat at least five portions of fruits and vegetables a day (more vegetables than fruits);
• include wholegrain at least in one of main meal per day;
• include different sources of iron that may be lacking due to a low intake of red meat. Good sources include dark green, leafy vegetables such as spinach, cabbage, kale and broccoli;
• use food rich in vitamin C to increase the absorption of iron from vegetables sources: small glass (150ml) of freshly squeezed orange juice, lemon sauce as a dressing, bell peppers, lettuce, tomatoes, kiwi, etc;
• include animal protein few times a week: salmon, eggs, low fat dairy and chicken;
• increase the ability to digest and reduce flatulence of the legumes with a long soaking, changing the water during before cooking, and when possible remove the skin.

Dr Andrea Rajnakova

GUIDELINE

The soaking of legumes, dried fruits, seeds, quinoa and amahrant is necessary to reduce the fermentation process in the intestine and remove all the substances (phytic acid and saponins) that inhibit the absorption of certain minerals.

HOW TO DO THE SOAKING

Legumes à overnight soaking (12-24-48 h) using warm water (1 cup per 5 g dried legumes) and 1tsp of lemon juice or apple vinegar. If possible, change the water during the soaking process using a new one. Remember, do not use the soaking water to boil the legumes, use a new one.

Chickpeas: 12-48 hours

Beans: 12-24 hours

Azuki beans: 12 hours

Lentils: 2 hours

Peeled lentil/red lentils: no soaking, just rinse under running water

Peas: 2 hours

Quinoa and amahrant à the ideal soaking is for 8-12 hours, after that rinse well under running water: you will notice a foam, which is caused by the elimination of saponins.

Seeds and nuts à Soak for 12 hours in a quantity of water equal to twice the amount needed to cover them. Add 1 tablespoon of whole salt for the seeds and 2 tablespoons for the nuts. After soaking, rinse and eat them immediately (they will have a tender texture) or they can be dried at a low temperature so you can stored them longer (those damp after a few days make molds).

Dry in a dryer for 12-24 hours. A normal oven will destroy them reducing their nutritional content. Nuts and backed seeds should be avoided because high temperatures can cause fatty oxidation, leading the formation of peroxides and hydroperoxides.

(do not use this method for chia or flax seeds)

BOILING TIME and METHODS

All legumes and cereals must be rinsed 3 times under running water, then put them in a new cold water in a pot.

Bring to a boil on a lively fire. As soon as it starts to boil, lower the flame to a minimum, so the water is just shaken.

To increase digestibility and reduce digestive disorders, add ½ onion, one carrot and one celery stalk to the cooking water to enhance also the flavor and smell of boiled vegetables.

Complete the cooking with the covered pot. At the end of boiling time in the pot there will be very little amount of water, this one will be reabsorbed in the final five minutes of resting.

You can also boil in water and at the end of the cooking you can remove the remaining water.

Chickpeas: 2 hours

Beans: 1,5 hours

Azuki beans: 1 hour

Lentils: 40 min

Peeled lentils: 20 min

Peas: 45 min

REFERENCE

• Schlemmer U et al. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75.
• H. Walter Lopez et al. Minerals and phytic acid interactions: is it a real problem for human nutrition? International Journal of Food Science & Technology Volume 37, Issue 7, pages 727–739, October 2002
• Sandberg and Andersson. The effect of dietary phytase on the digestion of phytate in the stomach and small intestine of human. Journal of Nutrition n. 118 (1988), pag. 469-473.
• López-González et al. Phytate (myo-inositol hexaphosphate) and risk factors for osteoporosis. Journal of Medicinal Food December 2008
• Sandberg and Andlid. Phytogenic and microbial phytases in human nutrition. International Journal of Food Science and Technology n. 37 (2002), pag. 823-833.
• Luo Y et al. Effect of several germination treatments on phosphatases activities and degradation of phytate in faba bean (Vicia faba L.) and azuki bean (Vigna angularis L.). J Food Sci. 2012 Oct;77(10):C1023-9.

Snacks ideas

Oat biscuits à our picture

(made with oat, banana, grated coconut, chestnuts flour, nuts/seeds) You can also add chocolate or cranberries.

Oat tahini biscuits à I do not have pictures

(made with oat, tahini, almon flour and maple syrup, pinch of salt and chocolate)

Fruit with chocolate and nuts à I do not have pictures

(fruit in pieces covered by melted dark chocolate and nuts/seeds)

Fruit with peanut butter or chocolate peanut butter à I do not have pictures

(2 pieces of fruit with peanut butter in the middle – need to be frozen)

Cocoa Meringues à I do not have pictures

(made with white eggs and sugar)

Chocolate mousse à our picture

(I like to put it in a yogurt or to have it as a mousse or icecream. Made with avocado, banana, fresh coconut water, raw cocoa, peanut butter)

Vegetables chipsà I do not have pictures

(baked vegetables chips made with kale, carrots, zucchini, avocado oil salt and pepper/paprika)

Vegetables stick with guacamole or hummus or tzaziki sauce or basil pesto or rocket and zucchini pesto à I do not have pictures

Chickpea focaccia à our picture

(made with chickpea, water, salt, extravirgin olive oil and fresh rosemary)

Oat and seeds creackers à our picture

(made with oat, seeds, pinch of salt, 1 tsp of honey, sage or rosemary, water)

Lunch ideas

Quinoa with vegetables + different types of protein à

I usually prepare quinoa/brown rice and baked/fresh vegetables and I mix them with different kind of protein. In the pircture is omelette egg with greek yogurt, salt and pepper (I also use tuna, salmon, chicken, legumes or feta/parmesan/hard cheese). Seasoned with oil, nuts or seeds and/or avocado.

Sweet potatoes chips with rosted vegetables and sesame chicken nuggets à I do not have pictures

Sandwich with hummus, cheese, grilled zucchini and cherry tomatoes confità I do not have pictures

Vegetable polpette with eggs and lentils flour  + yogurt and tahini sauce with vegetable sticks à I do not have pictures

Fresh spring roll with cooked salmon or tuna, avocado and peanut sauce à I do not have pictures